Eight Important Health Screens Commonly Overlooked from Dr. Mercola
Eight Important Health Screens Commonly Overlooked from Dr. Mercola
September 24, 2018
Story at-a-glance
While studies
suggest the health of Americans suffers due to excessive, unnecessary
and/or ineffective medical tests and treatments, certain lab tests can
offer truly important clues about your health
Some of the
most valuable tests are rarely ordered by conventional physicians. These
include the omega-3 index, ferritin, RBC magnesium, homocysteine and
LDL particle number
Other important lab tests include vitamin D, fasting insulin and C-reactive protein
You may also
consider doing a GGT test. Not only will it tell you if you have liver
damage, it’s also an excellent marker for excess free iron and is a
great indicator of your sudden cardiac death risk
As of 2014,
individuals (or a person designated by the patient) have the right to
gain direct access to their laboratory test reports without having to
have them sent to a physician first
By Dr. Mercola
While studies suggest the health of Americans suffers due to
excessive, unnecessary and/or ineffective medical tests and treatments,
certain lab tests can offer truly important clues about your health.
Unfortunately, some of the most valuable tests are rarely ordered by
conventional physicians.
What’s more, the reference ranges provided on lab test reports are
often misleading, as what’s considered “normal” is not necessarily ideal
for optimal health. So, which lab tests are really worth getting on an
annual basis, and what are the ideal reference ranges you’re looking
for?
I wrote this chapter for my new book on partial fasting that is
coming out in the spring, but it was so important that I wanted to give
it to you now for free. So, below is a list of eight of the most
important lab tests that are frequently overlooked.
No. 1 — Vitamin D
Optimizing your vitamin D is one of the easiest and least expensive
things you can do for your health. My recommendation is to get your vitamin D level tested twice a year, when your level is likely to be at its lowest (midwinter) and highest (midsummer).
This is particularly important if you’re pregnant or planning a
pregnancy, or if you have cancer. Based on the research done and data
collected by GrassrootsHealth, 40 ng/mL (100 nm/L) is the cutoff point
for sufficiency to prevent a wide range of diseases.
For example, most cancers occur in people with a vitamin D blood level between 10 and 40 ng/mL,1,2
and published data suggests a whopping 80 percent of breast cancer
recurrences — 4 out of 5 — could be prevented simply by optimizing
vitamin D and nothing else.3,4
For optimal health and disease prevention, a level between 60 and 80 ng/mL (150 to 200 nm/L) appears to be ideal.5
While the American Medical Association claims 20 ng/mL is sufficient,
research suggests 20 ng/mL is barely adequate for the prevention of
osteomalacia, and clearly far too low for other disease prevention or
improvement.
When it comes to dosage, you need to take whatever dose required to
get you into the optimal range, with 40 ng/mL being the low-end cutoff
for sufficiency. Research6
suggests it would require 9,600 IUs of vitamin D per day to get 97.5
percent of the population to reach 40 ng/mL, but there’s a wide variance
in individual requirements.
If you’ve been getting regular sun exposure, have eaten vitamin
D-rich foods such as beef liver, mushrooms and organic free-range egg
yolks7
and/or taken a certain amount of vitamin D3 for a number of months and
retesting reveals you’re still not within the recommended range, then
you know you need to increase your dosage.
Over time, with continued testing, you’ll find your individual sweet
spot and have a good idea of how much you need to take to maintain a
year-round level of 40 to 60 ng/mL. GrassrootsHealth offers vitamin D
testing at a great value through its D*Action study, and has an online vitamin D calculator you can use to estimate your vitamin D3 dosage once you know your current serum level.
No. 2 — Omega-3 Index
Like vitamin D, your omega-3 level
is also a powerful predictor of your all-cause mortality risk and plays
a vital role in overall health, especially your heart and brain health.
Recent research8
funded by the National Institutes of Health found having a higher
omega-3 index was associated with a lower risk for cardiovascular
events, coronary heart disease events and strokes. Omega-3 also helps
improve pain, especially when combined with vitamin D.
(Omega-3 fats are precursors to mediators of inflammation called
prostaglandins, which is, in part, how they help reduce pain.
Anti-inflammatory painkillers also work by manipulating prostaglandins.)
The omega-3 index is a blood test that measures the amount of EPA and
DHA omega-3 fatty acids in your red blood cell (RBC) membranes. Your
index is expressed as a percent of your total RBC fatty acids.
The omega-3 index reflects your tissue levels of EPA and DHA and has
been validated as a stable, long-term marker of your omega-3 status. An
omega-3 index over 8 percent is associated with the lowest risk of death
from heart disease. An index below 4 percent puts you at the highest
risk of heart disease-related mortality. If you're below 8 percent,
increase your omega-3 intake and retest in three to six months.
You can save money by getting the combined vitamin D and omega-3 index testing kit, offered by GrassrootsHealth as part of its consumer-sponsored research.
Your best sources of animal-based omega-3 are small, cold-water fatty fish such as anchovies, herring and sardines. Wild Alaskan salmon
is another good source that is low in mercury and other environmental
toxins. These fish are also a decent source of vitamin D, making them
doubly beneficial.
If you’re not eating these foods on a regular basis, your
alternatives include fish oil and krill oil. The latter is my preferred
choice, as it contains DHA and EPA
in a form that's less prone to oxidation. The fatty acids in krill oil
are also bound to phospholipids, which allow the DHA and EPA to travel
efficiently into your hepatic system; hence they're more bioavailable.
Studies9 have shown that krill oil may be 48 times more potent than fish oil.
No. 3 — Fasting Insulin
Insulin resistance is a driving factor for virtually all chronic
disease, making fasting insulin testing a really important health
screen. Any meal high in grain and sugar carbs typically generates a
rapid rise in your blood glucose. To compensate, your pancreas secretes
insulin into your bloodstream, which lowers your blood sugar. If you did
not have insulin to do this, you would go into a hyperglycemic coma and
die. Insulin, however, will also catalyze the conversion of excess
sugar into fat cells.
Typically, the more insulin you make, the fatter you become. If you
consistently consume a high-sugar, high-grain diet, your blood glucose
level will be correspondingly high and over time your body becomes
desensitized to insulin, requiring more and more insulin to get the job
done.
Eventually, you become insulin resistant and prone to weight gain,
then prediabetic, and then you enter full-blown diabetes. Prediabetes10 is defined as an elevation in blood glucose over 100 mg/dL but lower than 125 mg/dl, at which point it formally becomes Type 2 diabetes.
However, any fasting blood sugar regularly over 90 mg/dL is really
suggestive of insulin resistance, and the seminal work of the late Dr.
Joseph Kraft suggests 80 percent — 8 out of 10 — Americans are in fact
insulin resistant.11
Although he recommended an oral glucose tolerance test, which also
measures insulin, this is a far more challenging test, and for most a
fasting insulin test will suffice.
The fasting blood insulin test is far better than a fasting glucose
test as it reflects how healthy your blood glucose levels are over time.
It’s important to realize it’s possible to have low fasting glucose but
still have a significantly elevated insulin level. And yes, it must be
fasting for at least eight hours, otherwise the results are nearly
meaningless.
A normal fasting blood insulin level is below 5, but ideally, you'll
want it below 3. If your insulin level is higher than 3 to 5, the most
effective way to optimize it is to reduce or eliminate all forms of
dietary sugar. Intermittent fasting, partial fasting and/or water fasting are also effective, and intermittent fasting combined with a ketogenic diet appears to be the most aggressively effective of all.
No. 4 — Serum Ferritin
A ferritin test is a laboratory blood test that measures the amount
of ferritin in your blood. Ferritin is the major iron storage protein in
your body, so the ferritin test is ordered as an indirect way to
measure the iron stores in your body.
For adults, I strongly recommend getting a serum ferritin test on an
annual basis, as iron overload can be every bit as dangerous as vitamin D
deficiency. While iron is necessary for biological function, when you
get too much, it can do tremendous harm by increasing oxidative stress.
When iron reacts with hydrogen peroxide, typically in your
mitochondria, dangerous hydroxyl free radicals are formed. These are
among the most damaging free radicals known and are highly reactive and
can damage DNA, cell membranes and proteins. They contribute to
mitochondrial dysfunction, which in turn is at the heart of most chronic
degenerative diseases.
Unfortunately, the first thing people think about when they hear
“iron” is anemia, or iron deficiency, not realizing that iron overload
is actually a more common problem, and far more dangerous.
Virtually all adult men and postmenopausal women are at risk for iron
overload since they do not lose blood on a regular basis and since
humans are not at all designed to excrete excess iron, it is simply
stored for a rainy day when you might need extra iron from some type of
trauma resulting in blood loss.
There’s also an inherited disease, hemochromatosis, which causes your
body to accumulate excessive and dangerously damaging levels of iron.
If left untreated, high iron can contribute to cancer, heart disease,
diabetes, neurodegenerative diseases and many other health problems,
including gouty arthritis.12
As with many other lab tests, the “normal” range for serum ferritin is far from ideal.13
A level of 200 to 300 ng/mL falls within the normal range for women and
men respectively, but if you’re in this range, know you’re virtually
guaranteed to develop some sort of health problem.
An ideal level for adult men and nonmenstruating women is actually
somewhere between 30 and 40 ng/mL. (You do not want to be below 20 ng/mL
or much above 40 ng/mL.) The most commonly used threshold for iron
deficiency in clinical studies is 12 to 15 ng/mL.14
You may also consider doing a gamma-glutamyl transpeptidase
(sometimes called gamma-glutamyltransferase or GGT) test. GGT is a liver
enzyme correlated with iron toxicity and all-cause mortality. Not only
will the GGT test tell you if you have liver damage, it’s also an
excellent marker for excess free iron and is a great indicator of your
sudden cardiac death risk.
In recent years, scientists have discovered GGT is highly interactive
with iron, and when serum ferritin and GGT are both high, you are at
significantly increased risk of chronic health problems, because then
you have a combination of free iron, which is highly toxic, and iron
storage to keep that toxicity going.15 To learn more, see “Serum Ferritin and GGT — Two Potent Health Indicators You Need to Know.”
No. 5 — High-Sensitivity C-Reactive Protein (hs-CRP)
The hs-CRP is a highly sensitive test16 that measures a liver protein produced in response to inflammation in your body, and chronic inflammation
is a hallmark of most chronic diseases.The lower your level the better.
Goal would be to be below 0.7 mg/dl. I like to keep mine under 0.2
mg/dl.
Conventional medicine will typically treat underlying inflammation
with nonsteroidal anti-inflammatory drugs or corticosteroids. Patients
with normal cholesterol but elevated CRP are also frequently prescribed a
statin drug. None of these drug treatments address the underlying cause
of the inflammation, and can do more harm than good in the long run.
Eating a healthy diet low in added sugars and higher in healthy fats,
optimizing your vitamin D and omega-3, lowering your insulin level and
exercising on a regular basis will all help to address chronic
inflammation. Certain herbs and supplements can also be useful,
including astaxanthin, boswellia, bromelain, ginger, resveratrol,
evening primrose and curcumin.17
One drug option that is both safe and effective is low-dose naltrexone.
Naltrexone is an opiate antagonist, originally developed for the
treatment of opioid addiction. However, when takin at very low doses, it
triggers endorphin production, which helps boost immune function, and
has anti-inflammatory effects on the central nervous system.18
No. 6 — RBC Magnesium
Magnesium deficiency is extremely common, and recent research19
shows even subclinical deficiency can jeopardize your heart health.
Magnesium is also important for brain health, detoxification, cellular
health and function, energy production,20,21 regulation of insulin sensitivity,22 normal cell division,23 the optimization of your mitochondria24 and much more.
Magnesium resides at the center of the chlorophyll molecule, so if
you rarely eat fresh leafy greens, you’re probably not getting much
magnesium from your diet. Furthermore, while eating organic whole foods25
will help optimize your magnesium intake, it’s still not a surefire way
to ward off magnesium deficiency, as most soils have become severely
depleted of nutrients, including magnesium.
Magnesium absorption is also dependent on having sufficient amounts
of selenium, parathyroid hormone and vitamins B6 and D, and is hindered
by excess ethanol, salt, coffee and phosphoric acid in soda. Sweating,
stress, lack of sleep, excessive menstruation, certain drugs (especially diuretics and proton-pump inhibitors) also deplete your body of magnesium.26
For these reasons, many experts recommend taking supplemental
magnesium. The recommended dietary allowance for magnesium is 310 to 420
mg per day depending on your age and sex,27
but many experts believe you may need 600 to 900 mg per day, which is
more in line with the magnesium uptake during the Paleolithic period.28
Personally, I believe many may benefit from amounts as high as 1 to 2
grams (1,000 to 2,000 mg) of elemental magnesium per day in divided
doses, as most have electromagnetic field exposures that simply cannot be mitigated, and the extra magnesium may help lower the damage from that exposure.
The key to effectively using higher doses, however, is to make sure
you avoid loose bowels as that will disrupt your gut microbiome, which
would be highly counterproductive.
One of the best forms is magnesium threonate, as it appears to be the
most efficient at penetrating cell membranes, including your
mitochondria and blood-brain barrier. Another effective way to boost
your magnesium level is to take Epsom salt (magnesium sulfate) baths, as
the magnesium effectively absorbs through your skin.
I prepare a supersaturated solution of Epsom salts by dissolving 7
tablespoons of the salt into 6 ounces of water and heating it until all
the salt has dissolved. I pour it into a dropper bottle and then apply
it to my skin and rub fresh aloe leaves over it to dissolve it. This is
an easy and inexpensive way to increase your magnesium and will allow
you to get higher dosages into your body without having to deal with its
laxative effects.
Optimizing your magnesium level is particularly important when taking
supplemental vitamin D, as your body cannot properly utilize the
vitamin if you’re your magnesium is insufficient.29,30 The reason for this is because magnesium is required for the actual activation of vitamin D.
If your magnesium level is too low, the vitamin D will simply get
stored in its inactive form. As an added boon, when your magnesium level
is sufficiently high, it will be far easier to optimize your vitamin D
level, as you’ll require a far lower dose.31 In fact, research32 shows higher magnesium intake helps reduce your risk of vitamin D deficiency — likely by activating more of it.
No. 7 — Homocysteine
Homocysteine is an amino acid in your body and blood obtained
primarily from meat consumption. Checking your homocysteine level is a
great way to identify a vitamin B6, B9 (folate) and B12 deficiency.
Vitamins B6, B9 and B12 help convert homocysteine into methionine — a
building block for proteins. If you don't get enough of these B
vitamins, this conversion process is impaired and results in higher
homocysteine. Conversely, when you increase intake of B6, B9 and B12,
your homocysteine level decreases.
Elevated homocysteine is a risk factor for heart disease, and when
combined with a low omega-3 index, it’s associated with an increased
risk of brain atrophy and dementia. Vitamins B6, B9 and B12
are also really important for cognition and mental health in general,
so identifying and addressing a deficiency in these vitamins can go a
long way toward warding off depression and other, even more serious,
mental health conditions. If you do take folate and/or B12 it would be
best to take the methyl forms of these vitamins.
No. 8 — NMR Lipoprofile
One of the most important tests you can get to determine your heart disease risk is the NMR LipoProfile,
which measures your low-density lipoprotein (LDL) particle number. This
test also has other markers that can help determine if you have insulin
resistance, which is a primary cause of elevated LDL particle number
and increased heart disease risk.
Conventional doctors will typically only check your total
cholesterol, LDL cholesterol, high-density lipoprotein (HDL) cholesterol
and triglycerides. However, these are not very accurate predictors for
cardiovascular disease risk, as it’s quite possible to have normal total
cholesterol and/or normal LDL cholesterol yet have a high LDL particle
number.
In a nutshell, it’s not the amount of cholesterol that is the main
risk factor for heart disease but rather it’s the number of
cholesterol-carrying LDL particles. The greater the number of LDL
particles you have, the more likely it is that you also have oxidized
LDL, which tend to be far more atherogenic.
Oxidized LDL is more harmful than normal nonoxidized LDL because it’s
smaller and denser. This allows it to penetrate the lining of your
arteries, where it stimulates plaque formation.
Some groups, such as the National Lipid Association, have started to
shift the focus toward LDL particle number instead of total and LDL
cholesterol, but it still has not hit mainstream. Fortunately, if you
know about it, you can take control of your health and either ask your
doctor for this test, or order it yourself.
There are several ways to test for your LDL particle number. The NMR
LipoProfile is offered by a lab called Liposcience, and is the test used
in most scientific studies on LDL particles. If your LDL particle
number is high, chances are you have insulin and leptin resistance, as
these are driving causes of high LDL particle numbers.
Endotoxins in your gut will also increase your LDL particle number,
and thyroid dysfunction may be at play as well. In the video above,
Chris Kresser, an acupuncturist and a licensed integrative medicine
clinician, explains how LDL particle number is influenced via these and
other mechanisms.
2014 Rule Gave Patients Direct Access to Lab Results
While there are hundreds of blood tests and other health screens
available, the eight reviewed in this article are, I believe, among the
most valuable, arming you with vital information you can then use to
take proactive steps to protect and improve your health.
In case you've ever wondered if you can get your lab test results
directly from the lab that conducted the testing, know that you do have
that right. In 2014, the U.S. Department of Health and Human Services
issued a final rule that grants individuals (or a person designated by
the patient) direct access to their laboratory test reports without
having to have them sent to a physician first.33
Clearly, doctors should not have exclusive rights to information
about your body, but prior to this rule, this wasn't a guarantee. The
final rule updated the Clinical Laboratory Improvement Amendments of
1988, allowing laboratories to give patients direct access to their lab
results.
Even so, it's not always as simple as it should be to get your
results without going through your doctor. Laboratories may require
patients to make requests for lab results in writing, and they may
charge you extra to mail or electronically deliver them.
Further, the rule states that most results must be made available to
patients within 30 days of the completion of testing, so depending on
the contentiousness of the lab, you may have to wait weeks to find out
crucial health information. Most tend to be fairly quick though.
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